Medical Bills: You Can Dispute Them and Often Win
Consumers may feel their medical bills are unyielding, inflexible, set in stone. But that’s not always true: A new study shows patients can often reap financial benefits by disputing charges that seem erroneous or by negotiating for financial relief.
Key Takeaways
- Don’t assume a bill is accurate: A recent study found that 86% of patients who didn’t question their bills did so because they didn’t think it would make a difference, but research shows the opposite is often true.
- There’s often room for negotiation: A significant number of patients who disputed their bills saw them corrected, reduced, or even canceled outright.
- Be proactive: Don’t just accept a bill at face value. Question charges, investigate potential errors, and advocate for yourself.
Why So Many Bills Are Wrong
A 2023 Consumer Financial Protection Bureau analysis of medical bills for adults age 65 and older found that patients "face a complex billing system with a high likelihood of errors and inaccurate bills." For example, erroneous insurance claims are a common mistake, often occurring when consumers have multiple insurance sources.
These billing inaccuracies can lead to:
- Missing or invalid claim data
- Authorization and precertification issues
- Missing medical documentation
- Incorrect billing codes
- Untimely filing of claims
All of these errors can ultimately result in claims being rejected that would otherwise be paid.
What Errors to Look For
When reviewing your bill, check for potential errors such as:
- Duplicate charges: Were you charged twice for the same service?
- Mismatched codes: Do the billing codes reflect the services you actually received?
- Out-of-network charges: Were you charged out-of-network rates for services you received in-network?
- Incorrect insurance information: Were you billed for services your insurance should have covered?
Strategies to Manage Unreasonable Bills
Here are a few tactics for managing those tricky medical bills:
1. Ask upfront for an estimate.
Before receiving services, inquire about the estimated cost. This can help you avoid unexpected charges.
2. Consider paying in cash.
In some cases, you’ll get a lower price by paying cash rather than using insurance. However, always check if paying in cash will affect your annual deductible.
3. Request an itemized bill.
Get a detailed breakdown of all charges. This will help you identify any potential errors.
4. Research fair market prices.
Use online tools or consult consumer-focused websites to validate the charges on your bill.
5. Call and question your bill.
Don’t be afraid to reach out to your provider’s billing office. Explain your concerns and request an adjustment.
6. Document all communications.
Keep a record of all conversations and any agreements made. This will help you if any disputes arise later.
Don’t Be Afraid to Advocate
The healthcare system is complex and prone to mistakes. Don’t be afraid to advocate for yourself. By taking the time to understand your bill and asking questions, you can potentially save money and avoid unnecessary stress. Remember: You have the right to question your charges and negotiate for a fairer price.
